Background

Research indicates that additional mental health risks emerge in times of economic change (Uutela, 2010). As people move down the socio-economic ladder due to unemployment, impoverishment and indebtedness, protective factors are weakened, risk factors are strengthened and mental health is negatively affected.

In Portugal, with already a 12-month prevalence of 22.9% for mental disorders in 2009 (Caldas de Almeida and Xavier, 2013), potential negative effects of the present economic crisis are, therefore, a cause of concern.

Asian economic crisis increased income-related inequalities in depression and suicide mortality (Hong et al., 2011; Chang et al., 2009). The full health impact of the 2008 world economic crisis remains to be seen, but reports of negative mental health effects are emerging.

In Greece, cross-sectional studies conducted in 2008 (Madianos et al., 2011), 2009 and 2011 (Economou et al., 2013) found an association between major depression and economic crisis. In Spain an increase in the prevalence of mental health disorders among primary care attendees was found between 2006–07 and 2010–11, with unemployment, mortgage payment difficulties and evictions as major risk factors (Gili et al., 2013), and an increase of poor mental health was found among men (Bartoll et al., 2013). Mean self-rated happiness in Ireland declined in 2005-12, and the use of tranquillizers increased (Kelly et al., 2013). In Iceland, psychological stress may have increased following the economic collapse, particularly among women in economically vulnerable groups (Hauksdóttir et al., 2013). In Slovenia, depressive and anxiety scores increased among employees after the crisis (Avčin et al., 2011). In England, mental health in men deteriorated within 2 years of the onset of the current recession (Katikireddi et al., 2012). Studies in Canada (Wang et al., 2010) and Hong Kong (Lee et al., 2010), concluded that the economic crisis was associated with an increase in the risk of major depression. In Portugal there was an increase in the estimated annual incidence of first episodes of depression in primary health care between 2004 and 2012 (Rodrigues et al., 2014).

After the 2008 economic crisis, rates of suicide increased in 54 European and American countries, particularly in men and in countries with higher levels of job loss (Chang et al., 2013). There was an increase in the prevalence of suicidal ideation and reported suicide attempts in Greece (Economou et al., 2013), and increased suicide rates were observed in Greece (Simou et al., 2014), Ireland (Kelly et al., 2013), England (Barr et al., 2012), and the US (Reeves et al., 2012).

Actions reported as effective in alleviating mental health impact of economic crisis include: accelerating mental health reforms involving primary care, active labour market support for unemployed people, family support programmes, debt relief programmes (Walbeck et al., 2012).

Further research is needed from repeated cross-sectional or longitudinal population surveys to better understand the relationship between economic recession and the incidence of specific mental disorders, and to develop innovative policies and interventions.

 


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Lisbon, by Luca Sartoni | CC BY-SA 2.0